Ichimura K, Tanaka T
Department of Otolaryngology, Faculty of Medicine, University of Tokyo, Japan.
J Laryngol Otol. 1993 Nov;107(11):1017-20. doi: 10.1017/s0022215100125149.
In order to elucidate the causal mechanism of trismus in head and neck cancer, 21 patients manifesting trismus out of 212 patients with malignant tumours in the head and neck (treated in Tokyo University Branch Hospital from 1983 to 1991) were reviewed. Nine patients developed trismus either by infiltration of the muscles of mastication or by reflex spasm. Trismus was considered to have developed as a result of irradiation in five cases and of surgical intervention in seven cases. In some cases of oropharyngeal cancer, CT revealed no evidence of tumour invasion into the infratemporal fossa when trismus occurred, suggesting that trismus was caused either by the reflex spasm of muscles or by microinvasion too small to be seen in CT films. Maxillary sinus tumours were often without trismus even when they extended posteriorly to the infratemporal fossa.
为阐明头颈癌患者牙关紧闭的发病机制，我们回顾了1983年至1991年在东京大学附属医院接受治疗的212例头颈部恶性肿瘤患者，其中21例出现牙关紧闭症状。9例患者因咀嚼肌受浸润或反射性痉挛而出现牙关紧闭。5例患者的牙关紧闭被认为是放疗所致，7例是手术干预所致。在一些口咽癌病例中，当出现牙关紧闭时，CT检查未发现肿瘤侵犯颞下窝的迹象，这表明牙关紧闭可能是由肌肉反射性痉挛或CT片上难以发现的微小浸润引起的。上颌窦肿瘤即使向后延伸至颞下窝，也常常不会出现牙关紧闭症状。
